This preprint is under consideration at BMC Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Ho-Chang Kuo
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3295-2984
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Desquamation of hands and feet is a common characteristic of Kawasaki disease (KD), and occurs in 68-98% of patients diagnosed with KD. In this study, we analyzed patients’ varying desquamation levels in their hands or feet, in correlation with clinical presentation, to assess the relationship.
Method We retrospectively reviewed children with KD who had follow-up visits in Kaohsiung Chang Gung Memorial Hospital’s pediatric outpatient department (OPD) during 2018 and 2019. We analyzed their age, laboratory data before intravenous immunoglobulin (IVIG) treatment, and coronary artery abnormalities (CAA) based on the desquamation level of their hands and feet.
Results We enrolled a total 112 patients in the study, and 92 patients (82.1%) had hand or feet desquamation. We found the hands’ high-grade desquamation was positively associated with age and segmented neutrophil percentage (p=0.047 and 0.029, respectively) but negatively associated with lymphocyte and monocyte percentage (p=0.03 and 0.006, respectively). Meanwhile, the feet’s high-grade desquamation was positively associated with total white blood cell count (p=0.033). Furthermore, we found that high-grade hand desquamation had less probability of CAA formation compared with that of a low grade (7.1% vs. 40.8%, p=0.016). We observed no significant difference in IVIG resistance between the groups.
Conclusion This report is the first to demonstrate that the desquamation level of hands or feet in Kawasaki disease is associated with different coronary artery abnormalities and laboratory findings. Physicians should be cautious of CAA formation, particularly in patients with low-grade hand peeling.
Keywords
Desquamation, coronary artery lesion, Kawasaki disease
Figure 1
Figure 2
Figure 3
Figure 4
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 29 Apr, 2020
No community comments so far
Editorial decision: Major revision
On 28 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 12 May, 2020
Reviewers invited
Invitations sent on 05 May, 2020
Reviewer #1 agreed
On 05 May, 2020
Reviewer #2 agreed
On 05 May, 2020
Editor assigned
On 24 Apr, 2020
First submitted
On 23 Apr, 2020
Submission checks complete
On 23 Apr, 2020
Editor invited
On 23 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at BMC Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Ho-Chang Kuo
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3295-2984
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 29 Apr, 2020
No community comments so far
Editorial decision: Major revision
On 28 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 12 May, 2020
Reviewers invited
Invitations sent on 05 May, 2020
Reviewer #1 agreed
On 05 May, 2020
Reviewer #2 agreed
On 05 May, 2020
Editor assigned
On 24 Apr, 2020
First submitted
On 23 Apr, 2020
Submission checks complete
On 23 Apr, 2020
Editor invited
On 23 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Desquamation of hands and feet is a common characteristic of Kawasaki disease (KD), and occurs in 68-98% of patients diagnosed with KD. In this study, we analyzed patients’ varying desquamation levels in their hands or feet, in correlation with clinical presentation, to assess the relationship.
Method We retrospectively reviewed children with KD who had follow-up visits in Kaohsiung Chang Gung Memorial Hospital’s pediatric outpatient department (OPD) during 2018 and 2019. We analyzed their age, laboratory data before intravenous immunoglobulin (IVIG) treatment, and coronary artery abnormalities (CAA) based on the desquamation level of their hands and feet.
Results We enrolled a total 112 patients in the study, and 92 patients (82.1%) had hand or feet desquamation. We found the hands’ high-grade desquamation was positively associated with age and segmented neutrophil percentage (p=0.047 and 0.029, respectively) but negatively associated with lymphocyte and monocyte percentage (p=0.03 and 0.006, respectively). Meanwhile, the feet’s high-grade desquamation was positively associated with total white blood cell count (p=0.033). Furthermore, we found that high-grade hand desquamation had less probability of CAA formation compared with that of a low grade (7.1% vs. 40.8%, p=0.016). We observed no significant difference in IVIG resistance between the groups.
Conclusion This report is the first to demonstrate that the desquamation level of hands or feet in Kawasaki disease is associated with different coronary artery abnormalities and laboratory findings. Physicians should be cautious of CAA formation, particularly in patients with low-grade hand peeling.
Figure 1
Figure 2
Figure 3
Figure 4
Loading...